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Symptoms are usually relatively minor in the earliest stages of the disease and may only present as decreased flexibility or a slightly hunched posture

doi: 10.1002/art.1780080429 139 SpenceJ

On the contrary, nine variant exons (exons 614 or v2-v10), located in the middle of the CD44 gene can be alternatively spliced and assembled with exons contained in CD44s, resulting in the formation of a plethora of CD44 variant isoforms, typical of cells of epithelial origin and several carcinomas